Song Lijun, Li Xiangjun, Wang Lulu, Cui Jian, Ma Teng
Breast Disease Center, Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China.
First Department of General Surgery, Weihaiwei People's Hospital, Weihai, 264200, Shandong Province, China.
Clin Transl Oncol. 2025 Apr 27. doi: 10.1007/s12094-025-03921-1.
With the emergence of novel anti-HER2 antibody drug conjugates, patients with HER2-low breast cancer have received increased attention. Tumor-infiltrating lymphocytes (TILs) are significantly associated with survival benefits in cancers. However, their prognostic value in patients with low her2 breast cancer is unknown. Therefore, we aimed to determine the relationship between TILs and recurrence in patients with HER2-low breast cancer.
Clinicopathological data were retrospectively collected from patients with human epidermal growth factor receptor 2 (HER2) low-expression breast cancer who underwent consultations at Qingdao University Affiliated Hospital. We determined the correlation between TILs and disease-free survival (DFS) followed by the threshold value of TILs using X-tile software. Survival was assessed using Kaplan-Meier analysis, and cox regression analysis was performed for recurrence risk modeling.
Our study showed a 15% TIL level was the optimal cutoff for DFS. The low and high TILs survival curves showed significant differences in the log-rank test (p = 0.009). Cox regression analyses found that lymph node stage, histologic grading, TILs, and Ki-67 were independent variables influencing the prognosis (p < 0.05). On this basis, we developed a risk prediction model to accurately predict the 3- and 5-year disease-free survival rates of patients with HER2-low breast cancer, the model demonstrated good overall performance.
TILs are associated with recurrence in patients with breast cancer and low HER2 levels. TILs > 0.15 is a reliable indicator of DFS. For patients with low TILs (≤ 0.15), extensive follow-up is required. These findings provide a basis for targeted, individualized treatment.
随着新型抗HER2抗体药物偶联物的出现，HER2低表达乳腺癌患者受到了更多关注。肿瘤浸润淋巴细胞（TILs）与癌症患者的生存获益显著相关。然而，它们在HER2低表达乳腺癌患者中的预后价值尚不清楚。因此，我们旨在确定TILs与HER2低表达乳腺癌患者复发之间的关系。
回顾性收集在青岛大学附属医院就诊的人表皮生长因子受体2（HER2）低表达乳腺癌患者的临床病理数据。我们确定了TILs与无病生存期（DFS）之间的相关性，随后使用X-tile软件确定TILs的阈值。采用Kaplan-Meier分析评估生存率，并进行Cox回归分析以建立复发风险模型。
我们的研究表明，15%的TIL水平是DFS的最佳临界值。低TILs和高TILs生存曲线在对数秩检验中显示出显著差异（p = 0.009）。Cox回归分析发现，淋巴结分期、组织学分级、TILs和Ki-67是影响预后的独立变量（p < 0.05）。在此基础上，我们建立了一个风险预测模型，以准确预测HER2低表达乳腺癌患者的3年和5年无病生存率，该模型显示出良好的整体性能。
TILs与HER2低水平乳腺癌患者的复发相关。TILs>0.15是DFS的可靠指标。对于TILs低（≤0.15）的患者，需要进行广泛的随访。这些发现为靶向、个体化治疗提供了依据。
